Signing Up Uninsured for Health Care a Big Challenge

When a California county wanted to encourage residents to buy health insurance earlier this year, officials employed a time-tested tactic for generating interest: nudity.

The Alameda County Social Services Agency’s ad campaign featured bare-skinned people who held up signs in strategic spots that read, “Cover your family.”

The use of naked people in ads about health care underscores the desperation felt by organizations and government entities that want to encourage enrollment as the launch of new coverage under the 2010 health care law approaches. On Oct. 1, people all over the nation can start signing up for coverage, which kicks in on Jan. 1, 2014.

One big question is whether uninsured people — especially healthy people — will get coverage or whether they’ll just pay a penalty for going without it, which in 2014 will be $95. That’s particularly true for young men without many medical needs, whose premiums will essentially subsidize everyone else. And if healthy people don’t sign up, then rates will be higher than they otherwise would be.

Enroll America — a nonprofit that hopes to spend more than $100 million to encourage people to sign up — is going after those men with a bank-shot strategy. The group plans to get out information not only to young guys but also to their nagging moms.

The Department of Health and Human Services needs all the help it can get from Enroll America and others to supplement federal and state efforts to attract interest. Federal officials say they will do all they can to reach out to uninsured people — from asking celebrities to plug the coverage on social media sites to sending details to churches to posting info on other agency websites.

But the HHS administrative budget was hit by a more than 5 percent annualized cut from the across-the-board sequester that took effect March 1. Cash-strapped federal officials also will run the new marketplaces in 26 states themselves, rather than handing the job to state officials. That’s more than originally envisioned.

Signing up the uninsured is a huge challenge that will require campaign-style tactics, said Enroll America President Anne Filipic, a former Democratic National Committee deputy executive director and 2008 Obama campaign field director.

Filipic most recently was deputy director of the White House Office of Public Engagement, working for Jon Carson. Carson now oversees Organizing for Action, the new iteration of the Obama campaign community-building group Organizing for America, which also will encourage people without insurance to buy it.

Enroll America was started with a push from the consumer group Families USA. The organization is funded by a wide range of groups, including health care industry officials with a stake in the success of enrollment such as hospitals, insurers, community health centers, Planned Parenthood women’s health centers, drug companies and major pharmacy chains. Many industry groups also are funding their own individual efforts to expand coverage, either through outreach or by creating separate local lobbying coalitions to convince state officials to expand Medicaid.

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March 13, 2015

Tom Williams/CQ Roll Call

Rep. Elijah Cummings, D-Md., right, hugs Harold Schaitberger, General President of the International Association of Fire Fighters, after the Congressman spoke at the IAFF's Legislative Conference General Session at the Hyatt Regency on Capitol Hill, March 9, 2015. The day featured addresses by members of Congress and Vice President Joe Biden.